DELIVER - Determinants for guideline-based care of elder cancer patients in statutory health insurance

Interdisciplinary, quantitative and qualitative care research- focused on social, medical and philosophical implications.

Runtime: 36 months
Commencement: 5 August, 2017

Funded by the german federal joint commitee (G-BA)

Team: Susanne Elsner, Frank Gieseler, Joachim Hübner, Alexander Katalinic (PI), 
Christoph Rehmann-Sutter, Jacqueline Schubert, Christina SchüesFrank Wörler.

Objectives: Improvement of care, characterization and assessment of influencing medical and personal factors to crucial decisions of elder patients in serious conditions.

Medical guidelines represent state-of-the-art medicine that is backed by scientific research. They are used to assure a high quality of care, which is exceedingly important in life- threatening diseases like cancer. Despite the superior results in life expectancy, studies show that guidelines are less frequently used in elder patients. The study DELIVER was designed to explore possible reasons, factors and mechanisms that contribute to the decision to back away from standard protocol.

DELIVER will use the findings of qualitative interviews as well as statistic data to reveal the process of decision-making and its influencing factors like medical evidence, administrative procedures and communication between patients, relatives and medical doctors. Furthermore, it will be crucial to examine the influence of individual preferences depending on age, disease and the personal concept of life.

Guided interviews with patients with breast or bowel cancer that are older than 70 years will be held at the beginning of the study. In addition to that, surveys with their treating doctors, relatives and specialized oncologists will complement to the patients perspective.

Subsequently, a quantitative study of the institute for social medicine and epidemiology will question the statistical relevance of the results. Based on a phenomenologico-hermeneutical analysis, DELIVERs empirical insights will lead to a better understanding of incisive decisions, their development and background-including the reasons for approval or rejection of an intensive cancer treatment.

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